CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 2, 1997, No 4

Increase of "High Risk Patients" Undergoing CABG?

B. R. Osswald, C. F. Vahl, S. Hagl

Abstract:
Over the last years a general trend of an increased number of patients undergoing CABG with known risk factors is to be observed. To obtain a more objective view a retrospective analysis of 2409 patients undergoing CABG from 1992 to 1995 was performed. By using univariate analysis, age over 80, left main disease, obesity and diabetes were exemplary for further known risk factors chosen and were found to indicate a trend to a higher relation of patients with those risk factors over the years. Since univariate analyses alone do not provide a weighed profile, the development of the Parsonnet Score over the years was investigated. The higher scores increased during the observed time period. Therefore a higher number of "high risk" patients undergo CABG. However, the 30-day mortality at the same time is slightly decreasing. Although the 30-day mortality rate does not increase, but even decreases during this time, the increase of "high risk patients" undergoing CABG should be seen critically. The inverse behavior of risk and 30-day mortality indicates on the one hand a potential improvement of perioperative strategies, on the other hand the value of conventional risk estimation is to be discussed. There seems to be the need to use, in a more extended way, the available refined methods which allow a reliable, individual risk-adjustment.

Keywords:
CABG, risk-adjustment, mortality, survival analysis

Address for Correspondence:

Reference:
(CVE. 1997; 2 (4): 228-230)

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